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Posts for tag: children's dental health


Getting kids ready to return to school always seems to be a challenge.  Wrapping up summer activities, getting school supplies and clothes purchased, and rearranging everyone’s schedules is often difficult, to say the least!

And then, if you have a child entering kindergarten or 9th grade, there’s also the dental screening exam that may have escaped your parental radar.  I can’t speak for anyone else, but I find it fairly easy to keep track of things that I do every week or every month…or even every year.  But when I only need to do it twice in a ten-year span, I have a tough time remembering when I’m supposed to do it.

Since I’m a dentist, I could propose a solution to have the screening required every year so it would be easier to keep track of, but I doubt if many parents, let alone the school systems across the state, would be pleased with that solution!

Instead, let me simply stress the importance of these two examinations.  For many of you parents, who bring your children to us twice a year, getting these forms filled out is easy.  It may be as simple as calling us and asking us to fill out the form and send it to you.  You may find when you are in that we’ll remind you that the forms need to be filled out, and since we stock the forms, we’ll simply do it for your children as part of their regularly scheduled visit when we’re already monitoring their oral health, the growth, and development of their jaws and eruption of their teeth, etc. 

But for some other parents, for many, many reasons, you haven’t gotten your children in to see us as regularly as would be helpful for them and as you might have wished.  At least for you, the state requirement for having these forms filled out, helps ensure that your children are getting some care, and at fairly important intervals. 

While every child grows at a different rate, these two ages allow me and our hygienists an opportunity to monitor the eruption of the child’s teeth and their oral health and development.  Beyond that, it’s a chance to determine if there is any decay or oral disease present that we can deal with before it becomes painful for the child. 

Cavities are the most common childhood infection and certainly one of, if not the most frequent, causes of time lost from school due to pain or serious infection causing swelling, etc.  By detecting cavities before they are causing active problems, I can treat them early and fairly easily for your children.  That’s FAR better than having to treat a problem when the area is already infected and painful – especially for your child!  The other thing these exams allow for is to evaluate your children for sealants – coatings on their molars that help prevent cavities from happening.  That’s a GREAT deal for the kids!

So call us TODAY and get your child scheduled for an examination and any needed treatment. You’ll be glad you did when the rest of the school year goes along without any emergency dental visits, and it is certainly a good plan for preventing dental problems!

By Dr. Bill Kuttler, DDS
October 30, 2016

Since Halloween is here and all of the stores are trying to encourage us to buy big bags of candy to hand out to all the trick or treaters, perhaps it is appropriate to discuss the idea of “good candy” and “bad candy”.  To put it more accurately, if not grammatically, “better candy” and “worse candy” because believe me, there is NO “good candy” even if some of it tastes that way....  There’s a reason that most witches and Jack O Lanterns are missing teeth...

Why am I such a killjoy on the subject of candy?  It’s estimated that the average person in the United States consumes about 130 pounds of sugar every year.  That adds up to over 1/3 pound per day per person.  If you put that into a pile of sugar cubes, it’s a pretty big pile!  And we all know that there is LOTS of sugar in candy.  So what? you might say.  Well, first, ignore dental health.  Our country is facing an epidemic of obesity – and lots of that excess fat is coming from sugar.  The number of kids who are overweight is skyrocketing, and unfortunately, habits that start when we’re kids often carry over into our adult lives.  Consider also the rapid increase in people who have diabetes and related health issues – there is strong evidence linking that increase to the increased consumption of sugar.

But since I’m a dentist, I’m not going to ignore dental health entirely.  Every time we consume sugar, acid is produced in our mouths, and it only takes about 20 seconds.  Then it remains in our mouths for about 30 MINUTES.  Since most candy is consumed between meals, and often at a fairly leisurely pace, that can account for a lot of HOURS of acid exposure in our mouths.  That’s what produces cavities.  While that may be good for my business, it most definitely isn’t good for anyone’s health!

Having made what I believe is a convincing case AGAINST sugar and candy, I’m also a realist.  I admit it, I eat sugar too, and I enjoy it.  I simply work at picking how much and when I choose to eat it.  There are definitely better and worse times and ways to consume it.

The best time to consume sugar (and believe me it is contained in an amazing number of foods and beverages – try reading the labels on everything you buy for a week) is with meals.  If that was the only time you had any sugar in your diet, you’d probably be consuming far less than the average person, AND you’d be doing far less damage to your body and your teeth!  So the “when” is fairly easy.  If you do slip in a “treat” between meals, consume it quickly – that will reduce the amount of time your mouth is exposed to it, so you’ll be reducing the amount of damage that is done to your teeth.

Now, I hope the title of this article kept you reading to this point.  So I’ll answer the question that you’ve probably been hoping for – what’s “good” candy?  First, eat candy that moves through your mouth quickly.  That means avoiding sticky items (sorry, but that means avoiding caramel apples!), or candy that is designed for you to suck on over a prolonged period.  Items that are tart stimulate saliva flow, and that helps to reduce the damage that the sugar causes.  Chocolate, some research has shown, is a good alternative.  There are some positive aspects to chocolate that help make up for the negatives.  That is especially true for dark chocolate – there’s actually some solid research that says dark chocolate is actually good for you (depending upon your other health concerns, of course).  When all else fails, choose moderation – I find that’s almost always a good decision....  

Oh, and please don’t forget to brush and clean between your teeth when you’re done eating – no matter what it is!  It’s a great habit to get into!

“I don’t want any x-rays today.” and “Do you have to take x-rays today?” are probably the two most common comments or questions we hear every week. I don’t hear them very often from our existing patients because they know our rationale about taking x-rays, but I hear it a lot from new patients coming into our practice.  When we discuss those concerns, most fall into three broad categories: cost, need, and radiation exposure.

In 2012, the American Dental Association revised their guidelines for taking x-ray films, working with the U.S. government’s Federal Drug Administration. They noted that multiple factors impacted when x-ray films should be taken: the patient’s age, symptoms, history (amount of previous problems, etc.), and the frequency of that person’s care, i.e., how often do they visit a dentist. For new patient adults, the recommendation was for either a panoramic film and bite-wing radiographs (cavity-detecting x-ray films) OR a full mouth series of films (about eighteen individual small films). For new patient children, the recommendation varied widely based almost completely on the child’s age and existing conditions. For current patients, the recommendations centered on problem-focused films, if necessary, and bite-wing films every six to thirty-six months based on the variables previously noted.

We all acknowledge that x-ray radiation is potentially harmful, although the amount of exposure to a person from dental films is very small compared to almost any other medical exposure. Indeed, we are exposed to far more radiation working outside all day than we are from dental films, but never-the-less, the more we can reduce that exposure the better.

The other area that has always intrigued me is the differences between what the ADA recommends and what the dental benefit industry allows payment for. While I understand that benefit plans attempt to cover an “average” need of the people they cover, those plans vary widely in what they do pay for. Some plans pay for a panoramic film or full mouth series of films as often as every three years while others only allow a single peri-apical film (a film that shows the whole tooth including the root) with a diagnosis of why it was taken. And bite-wing films are often allowed once a year, but not with every plan. My sense is that these plans institute their allowances for a variety of reasons related to marketing and expense control (leading to profit for them), but rarely with the patients’ best interests in mind. 

In our practice, we follow the ADA guidelines closely. We take initial films on new patients unless we can get reasonably current films from their previous dentist – then we sometimes don’t need to take any. For our existing patients we almost never take bite-wing films more frequently than once a year, and for most of them it is about once every two years or more. That interval allows us to monitor changes in their teeth and bone levels adequately without more frequent exposure. Then every six to twelve years, we take a new panoramic film or full mouth series so we can evaluate the complete mouth more thoroughly.

So what is the cost? What I’ve learned from asking people is that the cost isn’t nearly as much as many people expect. In our office, single films cost between $22 and $30 each based on many variables while panoramic films range in cost from $95 to $110. Many of our patients tell me that’s nowhere close to what they expected.

I think I’ve already addressed “need” in my previous comments, but let me add that if you wonder why your dentist is recommending taking certain films, talk to her or him about it. You ought to get a clear answer that makes sense to you. If you don’t, then talk more about it. I literally review each person’s history before each of their appointments with us, and based upon that review, I determine what films we should or should not take at that visit. I prescribe it based on their needs and their current and historic circumstances.

As for radiation exposure, there is no question that less is better, but I am always looking at it from a perspective that in business is called “ROI.” That means “return on investment.” By that I mean that I’m always asking myself “Do YOU, as my patient, get a return of important information that allows me to better care for you from your investment of radiation exposure, hassle, and dollars spent?” Only if the answer is yes, do I recommend that we take the films.

I hope this has been helpful. As always, if you have questions, give our office a call, and we can discuss it further with you.

This article originally appeared in Dubuque 365 magazine.

By Bill Kuttler, DDS
August 31, 2015

As I write this article, a new school year is just getting underway. I’ve lost count of the number of people who have been telling me (ever since the 4th of July actually) that the summer is over. I always chuckle at that since for me summer usually lasts well into September, if not October, in terms of beautiful weather, etc. But then I must admit, I don’t have to factor in the back-to-school rush of shopping for school supplies and getting kids ready for those first days back in the classrooms.

To add one more thing to that “to do” list, I want to add getting your children to the dentist. In my experience that is often not the first thing that occurs to parents as they go down their check list. And it isn’t that I think “back to school check-ups” are a big deal–I don’t. What I think is a REALLY big deal is having your children seen regularly by the same dentist. And by regularly, I mean at least once per year and for most children twice a year (and there are some children who would benefit greatly from being seen even more often than that!)

There are two points I’d like to emphasize and explain from that previous paragraph. First, why do I stress the “same” dentist? And second, why do I feel strongly about the frequency of visits?

I believe in prevention. My greatest joy is seeing kids that I’ve watched grow up graduate from high school, and then perhaps college, and never have a cavity. And it doesn’t usually happen by accident. But it can, and often does, happen. In my experience it happens because the children’s parents are committed to good dental health and the dental personnel (dentist, hygienist, dental assistants) get to know the children, learn how to best work with them and motivate them, and serve as their “cheering squad”. In other words they form relationships with those children. And like most of us, children respond positively to that. Beyond what I believe is a HUGE aspect (i.e., building relationships), having the same dentist monitor growth and development and evaluate changes in tooth structure also provides a huge benefit for everyone.

I am often amazed when people transfer their care to a new dentist when that new dentist doesn’t want previous x-ray films. That history contained in those films is something I evaluate every time I see a patient. It helps me determine how often I need to take new films (potentially saving someone money and certainly x-ray exposure) and, even more importantly I believe, whether or not any dental disease present is active, progressing, or simply “old news”. We have patients in our practice that have had “beginning” decay on teeth for ten or more years. If it isn’t progressing, it almost always is “arrested”. That’s a term that dentists use to mean it has stopped and usually once that happens, it doesn’t ever progress. So people with arrested decay don’t need fillings, but without that history, those areas often look suspicious, and we dentists are trained to treat suspicious areas. So that’s another really important aspect of having a dental “home” where, if I can use the line from the TV show “Cheers”, “everyone knows your name” (and your mouth!)

Frequency of dental visits has been a subject of debate both within and outside of dentistry for many years. And the importance of “frequent” visits varies from child to child. Without getting into issues that pertain more to adults, for children the issues relate to susceptibility to decay (that is, do they get lots of cavities), growth and development, and helping them develop healthy dental homecare habits.

With children that have lots of decay, we want to be working with their parents as well as them, and we utilize a variety of strategies to help reduce and ultimately eliminate the number of problems (cavities). While we don’t always succeed, we improve things more often than not. The concerns about growth and development are somewhat more subtle but often have a large impact over the years. By watching how things change in your child’s mouth, we can suggest strategies to minimize problems and time referrals for braces, etc. when it is necessary. Sometimes timing is truly everything!

So what I’m suggesting here is that you use this time to schedule dental appointments for your children with us. We want to develop a long-term relationship with both you and your children, and we want you to feel good about asking us questions about your children’s mouths. We like kids and want to help them… and we hope they like us as well! And if that visit doesn’t happen until mid-September, that will still be OK. Then we can find out how your children like their new teachers!

I think this must be a “trick” that Halloween is nearly here again. It seems like I was dressed up like a giant tooth only last week (I bet that is a scary picture for most of you)! But with the leaves turning color and falling off the trees, I guess fall has arrived, and Halloween is certainly a fun part of that.

Halloween, somewhat justifiably, has a reputation as the dentist’s least favorite holiday. (Although some of our clients tell me that I should love it based on their beliefs that it creates lots of dental problems for me to solve.) In reality, I’m not really “for” or “against” it. At our home we often hand out toothbrushes to trick or treaters as our subtle way of encouraging dental health, but I don’t believe that one day matters all that much in the big picture. (Or even one week or month, depending on how long people keep the treats around.)

I believe people’s dental health is built on a combination of genetics, “inheritance”, and habits. First, there is evidence that people inherit through the genes they receive from their parents a tendency toward dental health or dental problems – including tooth decay, gum disease, and crowded teeth. Second, we know that parents pass the bacteria that live in their mouths to their children, especially when they are infants. Therefore, if those parents have active dental problems due to the types of bacteria they have (and we know some “bugs” actively cause dental disease while others don’t seem to cause problems), their children are “inheriting” that tendency to have dental disease and that may actually be a bigger factor than genetics. (That’s why the healthier mom and dad are dentally, the more likely that their children will also have few problems.)

So, third, let’s focus on the habits that impact everyone’s dental health. We can summarize those in two general categories: self care and diet. And self care can be placed in three “boring” areas: brushing wherever the toothbrush can reach, cleaning between the teeth where a toothbrush can’t reach, and using fluoride to raise the resistance of teeth to cavities. I say it’s “boring” because none of this is new information.

The good news is that in the last few years there are some very cool gadgets on the market that help with the brushing and cleaning between teeth. They are fun to use, far easier to use than conventional brushing and flossing, and they are often far more effective as well. Ask your dentist or dental hygienist about them. Or, if you’d rather, call our office, and we can help with some suggestions. But please, don’t make this into the “trick” part of the season - ask BEFORE you purchase anything. Just as there are better and worse Halloween costumes, some of the clever looking dental gadgets are just that: clever looking. We want you to spend your loot wisely on something that works specifically for you! And often that takes some helpful coaching.

Clearly the category that is most relevant to Halloween is diet. Most treats given out at Halloween are actually “tricks”. They are high in sugar, often are also high in fat, and are almost always low in nutrition content. So staying away from them is desirable, BUT short term exposure isn’t likely to create dental problems. It would be ideal if those treats are eaten with meals because between meal snacks cause a larger problem than meals. And it would be great if they were consumed within a few days and anything left over was disposed of. Those two approaches, taken together, will eliminate any long term dental consequences. Even better, if these approaches are taken all year long, the trick and treat of Halloween will turn into a life-long TREAT for your mouth!

This article originally appeared in Dubuque 365ink magazine. It is republished with permission from the publication.